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[quote]The impetigo lesions were unusually circinate in character, so much so in fact as to simulate a tinea to a certain extent, though the fact that the edge showed an even formation of bulla rather than closely set miliary vesicles made me confident that it was not ringworm. I examined part of this blister, and was surprised to find that there were numerous examples of Demodex folliculorum adhering to the epidermis.
Numerous comedones were then examined and smears from the unaffected skin as he was seborrhoeic, and no demodex was found in these specimens.
A fourth case was seen soon after which did not show the circinate lesion quite so obviously, and again the demodex was found in the lesion but not elsewhere.
In ordinary impetigo I have been unable to find the demodex.
One of the cases was treated with mild sulphur ointment and was cured in a week. I have not found that sulphur is a good treatment for ordinary impetigo, though I am aware that Unna has claimed that it is. I therefore think that the demodex has an aetiological relationship with the lesion. It may be that it carries the streptococcus into the epidermis, or it may be the actual irritant.
I have from time to time seen patients who have given a history of a scabby dermatitis of the face, " caught while treating a dog with the mange," but I have not seen the disease in its active state. One form of mange in dogs is accompanied and probably caused by a demodex as far as I know indistinguishable from the human Demodex folliculorum.
The lesions already described as associated with the demodex, as far as I can ascertain, are: discoloration of the
skin, especially. around the mouth, obstinate acne, rodent ulcer, and epithelioma. I have provisionally named this disease " demodex impetigo."[/quote]
[quote]Demodex mite is an obligate human ecto-parasite found in or near the pilo-sebaceous units. Demodex folliculorum and Demodex brevis are two species typically found on humans. Demodex infestation usually remains asymptomatic and may have a pathogenic role only when present in high densities and also because of immune imbalance. All cutaneous diseases caused by Demodex mites are clubbed under the term demodicosis or demodicidosis, which can be an etiological factor of or resemble a variety of dermatoses. Therefore, a high index of clinical suspicion about the etiological role of Demodex in various dermatoses can help in early diagnosis and appropriate, timely, and cost effective management.
Keywords: Demodex, demodicosis, demodicidosis, ecto-parasite[/quote]
Terpinen-4-ol is the Most Active Ingredient of Tea Tree Oil to Kill Demodex Mites
Sean Tighe; Ying-Ying Gao; Scheffer C. G. Tseng
Translational Vision Science & Technology November 2013, Vol.2, 2. doi:10.1167/tvst.2.7.2
[quote] Purpose: : To determine the active ingredient in tea tree oil (TTO) responsible for its reported killing effect on Demodex mites, the most common ectoparasite found in the human skin extending to the eye.
Methods: : Using a reported in vitro killing assay to measure the survival time of adult Demodex folliculorum up to 150 minutes, we have screened serial concentrations of 13 of the 15 known ingredients of TTO (ISO4730:2004) that were soluble in mineral oil and examined their synergistic relationships in killing mites. The most potent ingredient was then tested for its efficacy in killing Demodex in vivo.
Results: : All ingredients exhibited a dose-dependent killing effect. Besides Terpinen-4-ol, the order of relative potency did not correlate with the order of relative abundance in TTO for the remaining 12 ingredients. Terpinen-4-ol was the most potent ingredient followed by a-Terpineol, 1,8-Cineole and Sabinene. Terpinen-4-ol, the most abundant ingredient in TTO, was more potent than TTO at equivalent concentrations and its killing effect was even observable at a mere concentration of 1%. Terpinen-4-ol exhibited a significant synergistic effect with Terpinolene, but an antagonistic effect with a-Terpineol in killing mites (both P < 0.05). In vivo, Terpinen-4-ol was shown to eradicate mites.
Conclusions: : The above finding suggests that deployment of Terpinen-4-ol alone should enhance its potency in killing Demodex mites by reducing the adverse and antagonistic effects from other ingredients in TTO.
Translational Relevance: : Terpinen-4-ol can be adopted in future formulations of acaricides to treat a number of ocular and cutaneous diseases caused by demodicosis.[/quote]
Spinulate demodicosis.: Primary human demodicosis depicting discrete, fine, whitish, partly yellowish, keratotic, spiky scaly changes involving sebaceous hair follicles in the background of faint erythema:
Papulopustular demodicosis. (a) Primary human demodicosis characterized by a typical protracting course involving the forehead of a 46-year-old man with agminated follicle-bound lesions in an irregular shape. (b) Microscopic examination of skin scrapings revealed more than 5 mites per cm2:
Papulopustular demodicosis. Primary human demodicosis displaying disseminate involvement of the face of a 64-year-old woman with mild keratotic inflammatory papules of different sizes in an asymmetric distribution:
Nodulocystic demodicosis. Primary human demodicosis with intense inflammatory reaction including pus and
suppurative succulent changes:
Crusted demodicosis of the face. Primary human demodicosis showing multiple partly confluent papulopustules with thick yellowish crusts: